Deck 8: Exercise for Impaired Balance

Question 1

As part of the treatment program to improve a patient's balance, you decide to utilize a balance training program recommended by Nitz and Choy.The components of this program include:

A)Group exercises that consist of practicing standing postures and walking and perturbation training.
B)Individual and group exercises emphasizing dynamic and multisensory activities delivered in a circuit mode.
C)Group exercises consisting of stretching, strengthening, and coordination exercises; body mechanics; survival training; and walking.
D)Home program consisting of lower and upper extremity exercises in sitting and standing positions.

Answer 1

B

Question 2

To maintain balance in condition 3 (standing on a firm surface wearing a dome) of the Clinical Test of Sensory Integration on Balance Test, a person must rely solely on:

A)Somatosensory and vestibular information.
B)Vestibular information.
C)Visual and somatosensory information.
D)Visual and vestibular information.

Answer 2

A

Question 3

As part of a patient's balance training program, you have her walk across a balance beam or on a line drawn on the floor.The motor strategy this patient is most likely retraining is the:

A)Ankle strategy.
B)Suspensory strategy.
C)Stepping strategy.
D)Hip strategy.

Answer 3

D

Question 4

When a hip strategy is used for balance control in response to a posterior displacement of the support surface, which muscle groups are activated and in what sequence?

A)Abdominals followed by the quadriceps
B)Quadriceps followed by the abdominals
C)Hamstrings followed by the paraspinals
D)Paraspinals followed by the hamstrings

Question 5

The most important neural structures for the integration and processing of sensory information for balance control are:

A)Basal ganglia, primary motor area, and cerebellum.
B)Basal ganglia, thalamus, and supplementary motor area.
C)Supplementary motor area, cerebellum, and basal ganglia.
D)Supplementary motor area, cerebellum, and thalamus.

Question 6

Individuals who become unstable or fall in condition 5 (standing on foam with eyes closed) and condition 6 (standing on foam wearing a dome) during the Clinical Test of Sensory Integration on Balance Test (Foam and Dome Test) most likely have deficits in:

A)Proprioception.
B)Somatosensation.
C)Vestibular function.
D)Vision.

Question 7

The vestibular system provides which of the following types of sensory information for balance control?

A)Muscle tension and length
B)Joint movement and position
C)Position of the head and body with respect to inertial forces
D)Position of the head relative to the environment

Question 8

An 82-year-old woman is referred to physical therapy with a history of two falls in the past month.She shows inadequate anticipatory control on the Functional Reach Test and is now expressing fear of falling.The patient lives alone and relies on her daughter for transportation.The best exercise program for this person is:

A)The Otego Home Exercise Program.
B)Circuit training as described by Nitz and Choy .
C)A Tai Chi exercise program.
D)An individualized walking exercise program that she can do with her daughter.

Question 9

The typical pattern of muscle activation associated with an ankle strategy to correct forward body sway is:

A)Gastrocnemius and hamstrings are activated simultaneously, followed by the paraspinals.
B)Gastrocnemius is activated first, then the hamstrings, followed by the paraspinals.
C)Paraspinals are activated first, then hamstrings, followed by the gastrocnemius.
D)Hamstrings, gastrocnemius, and paraspinals are activated simultaneously.

Question 10

The center of gravity in most adult humans is located slightly:

A)Posterior to the L2 vertebra.
B)Posterior to the S2 vertebra.
C)Anterior to the L2 vertebra.
D)Anterior to the S2 vertebra.

Question 11

To improve a patient's dynamic postural control using visual and vestibular inputs, the most appropriate activity for the patient to perform is:

A)Standing on a foam surface with feet apart and eyes open.
B)Marching in place on a firm surface with eyes open.
C)Walking with a narrowed base of support on foam with eyes open.
D)Walking with a narrowed base of support on a firm surface with eyes closed.

Question 12

The semicircular canals of the vestibular system would contribute the most to balance control during which of the following activities?

A)Standing and quickly turning the head to look at a person
B)Sitting in a chair reading a newspaper
C)Standing on a bus that suddenly accelerates forward
D)Standing on an elevator that suddenly accelerates downward

Question 13

The elderly and individuals with diabetes who have peripheral neuropathy in the lower extremities might experience balance deficits and increased risk for falls due to:

A)Inability to generate motor output to regain balance.
B)Decreased joint position sense in the feet, reducing ability to use ankle or hip strategies to maintain balance.
C)Reduced somatosensation in the lower extremities.
D)Inability to participate in balance exercise programs or activities.

Question 14

While testing a patient's balance, you have the patient perform a series of activities, starting with those that require a low level of balance control and progressing to more difficult tasks.Of the following, the task that requires the greatest amount of balance control is:

A)Catching and throwing a ball while sitting.
B)Raising the opposite arm and leg while in the quadruped position.
C)Walking with one foot placed in front of the other.
D)While standing, balancing on one leg for 10 seconds.

Question 15

During an examination of a patient who has a history of episodic falls, you observe the patient performing functional tasks to determine how she loses her balance.You note that the patient becomes unsteady whenever she picks up objects from the floor or reaches for objects in a kitchen cupboard.These findings most likely indicate a control deficit in:

A)Anticipatory balance.
B)Reactive balance.
C)Static balance.
D)Sensory organization.

Question 16

To prevent falls and maximize safety while lifting heavy objects from the floor, an elderly patient is instructed to:

A)Bend at the knees as far as possible, keeping the back straight and placing the load between the legs.
B)Keep the knees straight, bend at the hips, keep the back straight, and pick up the load quickly.
C)Bend at the knees partially while keeping the back straight and pick up the load slowly.
D)Bend the knees partially and rotate and laterally bend the back to lift the load to one side of the hips.

Question 17

Individuals with somatosensory deficits in the lower extremities, such as peripheral polyneuropathies, tend to use which of the following motor strategies in response to balance disturbances?

A)Ankle strategy
B)Hip strategy
C)Stepping strategy
D)Suspensory strategy

Question 18

Which of the following terms is defined as "the sway boundaries in which an individual can maintain equilibrium without changing his/her base of support"?

A)Center of mass
B)Limits of stability
C)Limits of pressure
D)Center of gravity

Question 19

The Romberg Test measures:

A)Anticipatory balance control.
B)Reactive balance control.
C)Static balance control.
D)Dynamic balance control.

Question 20

Mrs.S is a 65-year-old woman with a history of falling due to episodic loss of balance.The medical diagnosis is "balance disorder." Which of the following tests is the best choice to administer to determine whether Mrs.S has a fear of falling?

A)Activities-Specific Balance Confidence Scale
B)Tinetti Performance-Oriented Mobility Assessment
C)Berg Balance Test
D)Functional Reach Test

Question 21

A 76-year-old community-dwelling man is referred to physical therapy for balance training.He reports no previous falls.His Timed Up-and-Go score is 15 seconds.The best setting for him to receive training is in:

A)An individual or community-based group exercise program.
B)A community-based group exercise program with individual supervision provided by trained staff.
C)A clinic with physical therapist or physical therapist assistant supervision.
D)At home with physical therapist or physical therapist assistant supervision.

Question 22

The outcome measure developed specifically to measure balance control during gait in people with vestibular disorders is the:

A)Timed Up-and-Go Test.
B)Tinetti Performance-Oriented Mobility Assessment.
C)Functional Gait Assessment.
D)Dynamic Gait Index.